Department of Neurology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China.
Department of Neurology, Tongxiang First People's Hospital, Jiaxing 314500, Zhejiang Province, China.
Zhejiang Da Xue Xue Bao Yi Xue Ban. 2024 Apr 25;53(2):151-159. doi: 10.3724/zdxbyxb-2023-0453.
To compare the effect of anesthesia mode on the neurological functional outcomes in patients undergoing endovascular treatment for acute posterior circulation ischemic stroke.
Clinical data of 656 patients undergoing intravascular therapy for acute posterior circulation ischemic stroke registered in online Acute Stroke Patients for Stroke Management Quality Evaluation Database from January 2017 to December 2022 were retrospectively analyzed. The data included 163 cases with conscious sedation and 493 cases with general anesthesia during the procedure. After propensity score matching, 428 patients were included in the analysis, including 155 cases in the conscious sedation group and 273 cases in the general anesthesia group. The differences of operation mode, etiology type, vascular recanalization, hemorrhagic transformation at 24 h, modified Rankin Scale (mRS) score at 3 months and mortality within 3 months were compared between the two groups. Binary logistic regression was used to explore the effect of different anesthesia mode on neurological functional outcomes.
There was a significant difference in operation mode between the two groups (<0.01), while there were no significant differences in etiology type, vascular recanalization, hemorrhagic transformation at 24 h, mRS score at 3 months or mortality within 3 months (all >0.05). Binary logistic regression analysis revealed that anesthesia modes were not significantly associated with functional outcomes of patients (=1.151, 95%: 0.751-1.765, >0.05).
Anesthesia mode (conscious sedation or general anesthesia) will not affect the neurological functional outcomes in patients with acute posterior circulation ischemic stroke undergoing endovascular treatment.
比较不同麻醉方式对急性后循环缺血性卒中血管内治疗患者神经功能结局的影响。
回顾性分析 2017 年 1 月至 2022 年 12 月在线急性卒中患者管理质量评估数据库中登记的 656 例接受血管内治疗的急性后循环缺血性卒中患者的临床资料。该数据包括 163 例术中接受镇静麻醉和 493 例接受全身麻醉的患者。经倾向评分匹配后，共纳入 428 例患者，其中镇静麻醉组 155 例，全身麻醉组 273 例。比较两组患者的手术方式、病因类型、血管再通、24 h 内出血转化、3 个月改良 Rankin 量表（mRS）评分及 3 个月内死亡率的差异。采用二项逻辑回归分析不同麻醉方式对神经功能结局的影响。
两组患者的手术方式差异有统计学意义（<0.01），而病因类型、血管再通、24 h 内出血转化、3 个月 mRS 评分及 3 个月内死亡率差异均无统计学意义（均>0.05）。二项逻辑回归分析显示，麻醉方式与患者的功能结局无关（=1.151，95%：0.751-1.765，>0.05）。
麻醉方式（镇静麻醉或全身麻醉）不会影响接受血管内治疗的急性后循环缺血性卒中患者的神经功能结局。
